By Jaboner Jackson 8 am | I’ve reviewed Peyton Manning’s neck injury and surgery with our team medical expert, Hassan A. Riaz, MD, MBA, twice already over the past two months. Dr. Riaz was pessimistic in both of our discussions. The Colts confirmed this weekend that Manning has been soliciting additional medical opinions regarding his neck injury and that he will not play in Week 1. Reports out of Indy have suggested that Manning will miss the first few weeks at least, which is consistent with what Dr. Riaz said a couple of weeks ago. I caught up with Dr. Riaz over the phone to hash out the latest developments. As always, Dr. Riaz is not treating the player being discussed and is relying upon publically available information to form his opinions.
What’s wrong with Peyton Manning?
Peyton had neck surgery this offseason for presumed degeneration of his cervical spine. This was his second spinal surgery. By all accounts, his progression thereafter has been stunted. Manning likely has the cervical bones of his neck pushing against the spine and nerve roots.
What kind of symptoms would Manning be experiencing if he had degeneration?
It’s same to assume that Manning has numbness and loss of strength in in his hands and arms. Manning was cleared to practice about a week ago. As I previously mentioned, he was symptom free at rest. But during vigorous physical activity, his symptoms returned. The most concerning aspect of Manning’s health is the probability that he has weakness in his arms. If he has diminished strength from his healthy baseline, he is unlikely to recover any time soon, if at all. It’s important to remember that the nerves of the cervical spine provide sensation and strength to the hands and arms.
How serious is this, Doc?
Very much so. Let me put it this was: if Manning were a bricklayer and applied for permanent disability through Social Security, he would ultimately get permanent disability because of the fact that he has already had two cervical surgeries to correct issues with pain and neurological deficiencies and has to use his hands to make a living.
A couple of months ago, you were hesitant about signing Manning to a long-term contract for this reason. Will Manning be able to return this season?
It’s impossible to know at this point. If he has continued weakness or tingling, he will not play this season. Period. Further injury can lead to more serious damage and even partial paralysis. No spine specialist would clear a patient to play contact football if the patient continued to have neurological symptoms.
Persistent neurological symptoms need months to heal. This mean we’re talking months before he comes back and not weeks. And I would not be surprised if Manning missed the entire 2011 season. A couple of weeks ago, Jim Irsay said that once Manning’s nerves regenerate properly, he’ll be ready to play. Frankly, I’m not sure what Mr. Irsay was talking about. Nerves do not regenerate. Function may return gradually once pressure on the spine and nerve roots is relieved but it’s not guaranteed. It was not as if Manning had a cut nerve that needed to regrow. No, not at all. Manning had and still does have pressure on his disc and nerve roots causing neurological symptoms.
By all accounts, Manning is a tireless worker, but this is not the kind of injury that can rehabbed away. It truly is a wait and see kind of injury. Like always, I’m crossing my fingers for Manning to make a full and speedy recovery.
Dr. Riaz is President of Mercy Medical Center outside of Long Beach, CA, where he is a practicing physician. He went to medical school at Keck School of Medicine of the University of Southern California and did his postgraduate training at Harbor-UCLA Medical Center. You may contact him through the webmaster at firstname.lastname@example.org.